Five common senses about brainstem tumor treatment

Brainstem tumors are mostly located in the pons, grow in an expansive manner, and can extend upward or downward along the nerve fiber bundles. Common tumors include glioma, ependymoma, and angioreticuloma. Due to their special location, a full understanding of brainstem tumor surgery should be obtained before treatment.

1. MRI examination of brainstem tumors has characteristic manifestations and can usually determine the extent of tumor development. There is no need for biopsy. Benign tectal gliomas often invade the entire tectum and progress slowly, so there is no need for experimental resection or biopsy.

2. Tumors with clear boundaries and that are displaced rather than infiltrated in the surrounding brainstem can be treated with resection surgery, such as cervical spinal gliomas, dorsal convex gliomas, and certain focal endogenous tumors.

3. Even if the brainstem tumor has clear boundaries on the image, it has no capsule and grows more or less along its boundaries. Performing a true total resection may damage the surrounding cranial nerve nuclei and long fascicles, so local resection should be chosen.

4. The surgical approach and strategy for brainstem tumor resection should be individually selected based on the location and extent of the tumor, as well as the nature of the tumor. Diffuse gliomas usually have no surgical indications and are not suitable for extensive resection.

5. Midbrain tumors are most likely to damage the extraocular motor nuclei and white matter pathways; dorsal convex tumors and focal endogenous pons tumors are more likely to damage the facial nerve nucleus and abducens nerve nucleus, and medullary tumors are more likely to damage the posterior cranial nerve nuclei and respiratory centers.